| NPI | 1922038595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: CA A41400) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: CA A41400) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2023-03-30 |